Currently, the provision of an adequate quantity of purified water, the chlorination of contaminated water sources, and the establishment of isolated areas for defecation pending appropriate sanitation systems, are measures taken to help prevent cholera outbreaks in refugee settings. Beyond prevention, the mainstay of cholera control remains appropriate case management to prevent mortality. The current approach taken is to provide the necessary supplies and equipment to manage cases after the epidemic has been recognized, an approach we define as reactive treatment. The recent availability of oral cholera vaccines, and the demonstration in large scale field trials that the inactivated whole-cell and B subunit vaccine is both safe and efficacious, has renewed interest in cholera vaccination as a potential public health measure to prevent cholera outbreaks in situations with high cholera incidence, such as refugee populations. In view of limited available resources, to assist in formulating policy decisions regarding appropriate public health measures to control cholera outbreaks in refugee situations, we are preparing a cost-effectiveness analysis of several alternative intervention strategies that incorporate case treatment and/or vaccination against cholera. The results to date indicate that in the absence of a vaccination intervention to control cholera in refugee settings, a preemptive treatment strategy (setting up the infrastructure and providing the supplies required to manage a cholera outbreak at inception of the camp) is expected to cost less and save more lives than the current reactive treatment strategy. If vaccination is to be incorporated into a treatment strategy, intervention strategies other than the combination of preemptive vaccination (vaccination of the whole refugee camp at inception of the camp) and preemptive treatment prevent no further cholera cases, prevent fewer cholera deaths, and cost more. The final analyses with precise estimates and the results of the sensitivity analyses should be available by September 1996, when the project is envisioned to end.